Due to the peculiar problems and difficulties associated with international carrier shipments, the buyer / receiver must complete ALL of the following form. Please ensure you have read and understood the IAS TERMS and CONDITIONS and the details about carrier shipments in the FAQ section.
My Carrier is: Airborne Express / DHL / Federal Express / UPS Carrier Payment Options: My Carrier Account Number is: ................................ OR Please charge my credit card. Card Type: Visa / MasterCard / JCB / Switch / Delta Name on Card: ......................................................... Card Number: .......................................................... Expiry Date: ....................... Switch Issue Number: ............... Switch Start Date: ............... (NOTE: The credit card option is ONLY available for Medical Doctors OR a patient's order accompanied with a valid prescription or orders being sent directly to a registered health professional's address). You do not require a prescription or your doctor's address if this order is for publications or audio cassettes. My Doctor's Address is: ........................................... ....................................................................... ....................................................................... (This is for verification only, your products will be sent using the details given in the SHIP TO ADDRESS section). This is not required for orders for publications or audio cassettes. Shipment Details Please send this shipment as: EXPRESS / EXPEDITED (where available) Please describe the products as: ...................................... (NOTE: Suggestions of food supplements, nutrients or pharmaceuticals are likely to flag a package for inspection by customs). Please value my shipment for customs at: US$.............. (Your package may attract taxes in your country). Please insure my shipment at: US$.............. (Remember this cannot be more than value placed for customs). I will send my prescription or doctor's note by: E-mail / Fax / Letter If you are ordering pharmaceutical products, we will wait its arrival to include in the package. This is not required for orders for publications or audio cassettes.
Declaration: I hereby declare that I accept full liability and responsibility for any and all charges, taxes and customs procedures for the above carrier consignment, including any return charges should the products need to be returned for any reason. I agree to the IAS Terms and Conditions and will also complete the product liability declaration on the store order form.
Tick Here........ Signed........................................... Date..................